目的 观察补肾活血方配合髓芯减压植骨内支撑术治疗早期股骨头坏死的临床效果.方法 选取2012年4月～2015年4月在宝鸡市中医医院就诊的83例早期股骨头坏死患者为观察对象.采用随机数字表法将其分成研究组(41例,53髋)和对照组(42例,57髋).对照组采用髓芯减压植骨内支撑术,研究组在行髓芯减压植骨内支撑术后第2天即给予中药汤剂补肾活血方治疗,持续治疗3个月.观察两组影像学疗效,并采用Harris评分法评价两组治疗前后髋关节功能变化.结果 治疗3个月后,研究组影像学疗效的总有效率(92.68％)明显高于对照组(80.95％),差异有统计学意义(P＜0.05).两组患者治疗前髋关节Harris总分及疼痛、功能、畸形、关节活动度评分比较,差异均无统计学意义(P＞ 0.05).与本组治疗前比较,两组治疗后髋关节Harris总分及疼痛、功能、畸形、关节活动度评分均显著提高,差异均有统计学意义(P＜0.05).研究组治疗后上述各项评分较对照组治疗后明显升高(P＜ 0.05).结论 补肾活血方配合髓芯减压植骨内支撑术治疗早期股骨头坏死能有效防治股骨头坏死,缓解疼痛,改善髋关节功能,提高关节活动度,值得临床推广.%Objective To observe the clinical effect of Bushen Huoxue Prescription cooperated with core decompression and internal support bone grafting in the treatment of early necrosis of the femoral head.Methods Eighty-three cases of patients with early necrosis of the femoral head treated in Baoji Hospital of Traditional Chinese Medicine from April 2012 to April 2015 were selected as research objects,and they were randomly divided into study group (41 cases,53 hip) and control group (42 cases,57 hip) by random number table method.The control group was given core decompression and internal support bone grafting,the study group was given Bushen Huoxue Prescription on the second day after core decompression and internal support bone grafting,treating for 3 months continuously.The imageology efficacy of the two groups was observed,and the changes of hip joint function in the two groups before and after treatment were evaluated by Harris scoring method.Results After treatment for 3 months,the total effective rate of imageology efficacy in the study group (92.68％) was obviously higher than that of control group (80.95％),there was statistically significant difference (P ＜ 0.05).There were no statistically significant differences of total scores of Harris and scores of pain,function,malformation,joint range of motion between the two groups before treatment (P ＞ 0.05).Compared with before treatment,the total scores of Harris and scores of pain,function,malformation,joint range of motion in the two groups after treatment were obviously increased,the differences were all statistically significant (P ＜ 0.05),and the scores above in the study group after treatment were all significantly higher than those of control group (P ＜ 0.05).Conclusion Bushen Huoxue Prescription cooperated with core decompression and internal support bone grafting can prevent and treat the early necrosis of the femoral head effectively,which can relieve pain,improve the hip joint function,increase the joint range of motion,it is worthy of clinical promotion.
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